Technical Note

Impact of Different Beam Energies on The Incidence of Thyroid Cancer in Breast Cancer Radiotherapy

Abstract

Purpose: During breast radiotherapy, the organs which are located out of the radiation field such as the thyroid are prone to secondary cancers. The present study aims to evaluate the risk of thyroid cancer in breast cancer radiotherapy in conventional and conformal radiation therapy.

Materials and Methods: The data related to the thyroid dose in radiotherapy of breast cancer from the study by Behmadi et al. were used. In their study, the thyroid dose was measured on the Alderson RANDO phantom for four different breast cancer treatment plans and two photon energies. Using the Biological Effects of Ionizing Radiation (BEIR) VII model, the risk of thyroid cancer was estimated in conventional and conformal plans with two photon energies (6 and 15 MV) in breast cancer radiotherapy.

Results: The Lifetime Attributable Risk (LAR) for thyroid cancer in the conventional technique was only 7.5% higher than that in the conformal technique. In the conventional treatment technique, LAR for thyroid cancer at 6 MV in all age groups was 17% higher than the 15 MV energy. However, the LAR for thyroid cancer in conformal technique at 15 MV energy was 50% higher than at 6 MV energy.

Conclusion: Applying high energy for radiotherapy of breast cancer, in the conventional technique, could reduce the risk of thyroid cancer. But at high energies, the risk of thyroid cancer in the conformal technique is considerably higher than that at low energy. Therefore, it is suggested that the impact of energies be evaluated to reduce the risk of thyroid cancer in breast cancer radiotherapy.

1- David S Shimm, "Perez and Brady's Principles and Practice of Radiation Oncology." International Journal of Radiation Oncology, Biology, Physics, Vol. 72 (No. 4), p. 1268, (2018).
2- Steve Braunstein and Jean L Nakamura, "Radiotherapy-induced malignancies: review of clinical features, pathobiology, and evolving approaches for mitigating risk." Frontiers in oncology, Vol. 3p. 73, (2013).
3- X George Xu, Bryan Bednarz, and Harald Paganetti, "A review of dosimetry studies on external-beam radiation treatment with respect to second cancer induction." Physics in Medicine & Biology, Vol. 53 (No. 13), p. R193, (2008).
4- EM Donovan, H James, M Bonora, JR Yarnold, and PM Evans, "Second cancer incidence risk estimates using BEIR VII models for standard and complex external beam radiotherapy for early breast cancer." Medical physics, Vol. 39 (No. 10), pp. 5814-24, (2012).
5- Rebecca M Howell, Sarah B Scarboro, SF Kry, and Derek Z Yaldo, "Accuracy of out-of-field dose calculations by a commercial treatment planning system." Physics in Medicine & Biology, Vol. 55 (No. 23), p. 6999, (2010).
6- Jessie Y Huang, David S Followill, Xin A Wang, and Stephen F Kry, "Accuracy and sources of error of out‐of field dose calculations by a commercial treatment planning system for intensity‐modulated radiation therapy treatments." Journal of applied clinical medical physics, Vol. 14 (No. 2), pp. 186-97, (2013).
7- Zeinab Momeni, Mohammad Bagher Tavakoli, and Maryam Atarod, "Estimation of the thyroid secondary cancer risk on the patient of standard breast external beam radiotherapy." Journal of medical signals and sensors, Vol. 8 (No. 4), p. 238, (2018).
8- Boram Lee, Sunyoung Lee, Jiwon Sung, and Myonggeun Yoon, "Radiotherapy-induced secondary cancer risk for breast cancer: 3D conformal therapy versus IMRT versus VMAT." Journal of radiological protection, Vol. 34 (No. 2), p. 325, (2014).
9- M Behmadi et al., "Evaluation of breast cancer radiation therapy techniques in outfield organs of rando phantom with thermoluminescence dosimeter." Journal of Biomedical Physics & Engineering, Vol. 9 (No. 2), p. 179, (2019).
10- US Environmental Protection Agency, "EPA radiogenic cancer risk models and projections for the US population." ed: Office of Radiation and Indoor Air Washington DC, (2011).
11- Hamid Ghaznavi, "Evaluation of Thyroid Cancer Risk After Laryngeal and Nasopharyngeal Radiotherapy." Thyroid, Vol. 1 (No. 2.70), pp. 1.51-1.26, (2020).
12- Michalis Mazonakis, Stefanos Kachris, and John Damilakis, "VMAT for prostate cancer with 6‑MV and 10‑MV photons: Impact of beam energy on treatment plan quality and model‑based secondary cancer risk estimates." Molecular and Clinical Oncology, Vol. 14 (No. 5), pp. 1-6, (2021).
13- S Elmtalab and I Abedi, "Investigating the out-of-field doses and estimating the risk of secondary thyroid cancer in high-grade gliomas radiation therapy with modulated intensity and 3D-conformal: a phantom study." International Journal of Radiation Research, Vol. 19 (No. 3), pp. 569-74, (2021).
14- Uwe Schneider, Marcin Sumila, and Judith Robotka, "Site-specific dose-response relationships for cancer induction from the combined Japanese A-bomb and Hodgkin cohorts for doses relevant to radiotherapy." Theoretical Biology and Medical Modelling, Vol. 8 (No. 1), pp. 1-21, (2011).
15- Giorgio Cartechini et al., "Proton pencil beam scanning reduces secondary cancer risk in breast cancer patients with internal mammary chain involvement compared to photon radiotherapy." Radiation Oncology, Vol. 15 (No. 1), pp. 1-10, (2020).
16- Emel Haciislamoglu, Yunus Cinar, Fatih Gurcan, Emine Canyilmaz, Gorkem Gungor, and Adnan Yoney, "Secondary cancer risk after whole-breast radiation therapy: field-in-field versus intensity modulated radiation therapy versus volumetric modulated arc therapy." The British Journal of Radiology, Vol. 92 (No. 1102), p. 20190317, (2019).
17- Quanbin Zhang et al., "Secondary cancer risk after radiation therapy for breast cancer with different radiotherapy techniques." Scientific reports, Vol. 10 (No. 1), pp. 1-12, (2020).
18- Pei-Ju Chao et al., "Propensity-score-matched evaluation of the incidence of radiation pneumonitis and secondary cancer risk for breast cancer patients treated with IMRT/VMAT." Scientific reports, Vol. 7 (No. 1), pp. 1-9, (2017).
19- Sajeev George Pulickal, Nikhil Sebastian, Reshma Bhaskaran, and P Aparna, "Effect of change in neck position on thyroid dose and volume in supraclavicular irradiation for breast cancer using conformal technique." Journal of Radiotherapy in Practice, pp. 1-5, (2021).
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IssueVol 9 No 3 (2022) QRcode
SectionTechnical Note
DOI https://doi.org/10.18502/fbt.v9i3.9650
Keywords
Breast Cancer Radiation Therapy Thyroid Cancer Biological Effects of Ionizing Radiation VII Model Secondary Cancer Risk

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How to Cite
1.
Ghaznavi H, Behmadi M. Impact of Different Beam Energies on The Incidence of Thyroid Cancer in Breast Cancer Radiotherapy. Frontiers Biomed Technol. 2022;9(3):231-236.